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Navy Surgeons in Iraq Wrangle With Trauma

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NEAR FALLUJAH, Iraq - Doctors with Bravo Surgical Company — known as the "Cheaters of Death" — fight their own quiet battles every day against the horrifying wounds of war.

"These injuries we never see at home," said one of the surgeons, Dr. Matthew Camuso of Los Angeles. "I mostly treated gunshot wounds and stabbing, but these injuries don't compare — you just don't have people blown up back home."

Dr. Michael Mazurek, an orthopedic surgeon and trauma specialist from Philadelphia, said he has seen "some horrific injuries" in the 90 days since coming to Iraq (news - web sites). "The tremendous force of the IED can devastate a torso," he says, referring to a roadside bomb.

As quickly as they can, the doctors of Bravo Company patch up U.S. soldiers who are often treated first at the scene of their injury by mobile doctors with backpack kits. Then, the wounded are quickly flown to military hospitals in Europe or to the United States if they are severely injured.

"What we saw as the most lifesaving factor was getting the wounded to us as soon as possible," said Dr. Kenneth Kelleher, the 58-year-old Navy captain who is company chief. "Then, it's all down to basic surgery, stop the bleeding, close holes and bowel — we basically work to save life over limb."

They work in a single-story concrete building that is deceptively austere. This Navy combat hospital houses two complete surgeries, with three operating tables, a 20-bed ward and state-of-the-art equipment, including digital X-ray, a well-stocked pharmacy and a laboratory complete with blood bank freezers.

The scene, once one of fierce urban warfare that lasted for a week in Iraq's former insurgent stronghold, is now quiet.

But during the most intense combat in the battle for Fallujah and in the mop-up military operations that followed, the hospital received about 800 patients — over 50 a day, Kelleher said. That compares with the earlier Oct. 17 record, when Kelleher's team treated 16 patients from three separate attacks in the area.

Mazurek says 10 surgeries in a single day of the battle were a personal record.

During Fallujah's urban combat, there were far fewer wounds from roadside bombs than are suffered elsewhere in Iraq, and far more gunshot wounds to arms and legs as Marines clashed house-to-house with holed-up insurgents.

By the time the chaos had ended, more than 50 Marines and eight Iraqi soldiers had been killed in the battle that U.S. military says also claimed the lives of 1,600 insurgents. Bravo Surgical also treated over 50 wounded Iraqi soldiers who fought alongside U.S. troops, as well as about 50 insurgents.

Combat hospitals, with front-line lifesaving crews such as Kelleher's, emerged from the 1991 Gulf War (news - web sites), Somalia and other Marine engagements. From their experience at the operating table, doctors learned they had to treat the wounded in those critical first minutes — what's called the "Golden Hour" — so getting them off the battlefield fast was of paramount importance.

That practice in Iraq is one reason for the 90 percent survival rate of U.S. soldiers, the highest in any war.

But this war is seeing more severe injuries and amputees than any other war, too. Mazurek, 36, says the toughest decision for him is whether a limb is salvageable.

"We are better at recovering limbs than we were 20 years ago simply because of the techniques, because we are generally better at what we do and the approach to 'mangled extremity' is different," he says. On the other hand, "a U.S. soldier has a better chance at getting the latest prosthesis, adequate rehabilitation than any other."

In other cases, there are no choices for the doctors to make.

"Unfortunately, it's the injuries on the battlefield that mostly select who is to live and who is not — those who die are mostly those who are immediately killed in action," Kelleher said.
http://story.news.yahoo.com/news?tmpl=story&u=/ap/20041208/ap_on_re_mi_ea/iraq_battlefield_hospital&cid=540&ncid=1480